红细胞分布宽度与急性脑梗死及短期预后相关性研究

Research of correlations between red blood cell distribution width and acute cerebral infarction and short-term prognosis

目的:探讨红细胞分布宽度(red blood cell distribution width,RDW)与急性脑梗死及短期(3个月)预后的关系。方法:选择住院急性脑梗死病人90例为脑梗死组,30名健康体检者为对照组。所有受试者均进行RDW测定。急性脑梗死病人按RDW中位数分为高RDW组(RDW>13.5%)和低RDW组(RDW≤13.5%)。急性脑梗死病人入院时采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分,在脑梗死发生后3个月采用改良Rankin量表(modified Rankin scale,mRS)评定功能恢复情况,根据mRS评分情况分为预后良好组(mRS≤2分)和预后不良组(mRS>2分)。结果:脑梗死组RDW显著高于对照组(P<0.01)。高RDW组NIHSS评分显著高于低RDW组(P<0.01);RDW与NIHSS评分呈显著正相关(P<0.01)。预后不良组RDW显著高于预后良好组(P<0.01)。用RDW预测急性脑梗死的ROC曲线下面积(AUC)=0.703,最佳界值为12.9%,灵敏度为66.67%,特异度为73.33%;用RDW预测急性脑梗死发生短期预后不良事件的AUC=0.831,切点为>13.5%时,灵敏度为88.46%,特异度为71.87%。结论:RDW可能是诊断急性脑梗死的重要参数,且对评估病人的严重性及短期预后有一定临床参考价值。

Objective: To evaluate the correlations between red blood cell distribution width( RDW) and acute cerebral infarction and short-term( 3 months) prognosis. Methods: Ninety patients with acute cerebral infarction and 30 healthy people were divided into cerebral infarction group and control group,respectively. The RDW in all cases were detected. The acute cerebral infarction group were divided into high RDW group( RDW > 13. 5%) and low RDW group( RDW≤13. 5%) according to the median of RDW. The National Institutes of Health Stroke Scale( NIHSS) scores in acute cerebral infarction patients when admitted to the hospital were evaluated,the functional recovery of patients after 3 months of acute cerebral infarction was evaluated using the modified Rankin scale( mRS). The acute cerebral infarction patients were divided into the good prognosis group( mRS ≤2 points) and poor prognosis group( mRS > 2 points) according to the mRS scores. Results: The RDW in cerebral infarction group was significantly higher than that in control group( P < 0. 01). The NIHSS score in high RDW group was significantly higher than that in low RDW group( P < 0. 01). The RDW was significantly positive correlation with the NIHSS score( P < 0. 01). The RDW in poor prognosis group was significantly higher than that in good prognosis group( P < 0. 01). The area under the receiver operating characteristic( ROC) curve was 0. 703 according to the RDW to identify the acute cerebral infarction,the optimal cut-off value,sensitivity and specificity were 12. 9%,66. 67% and 73. 33%,respectively. The AUC of the short-term adverse prognosis was 0. 831 according to the RDW to predict the acute cerebral infarction,and the critical point was more than 13. 5%,the sensitivity and specificity were 88. 46% and 71. 87%,respectively. Conclusions: The RDW may be an important parameter in the diagnosis of acute cerebral infarction,which has a certain clinical reference value in assessing the severity and short-time prognosis of patients.